Individual provider · NPI-1

Dr. Jerry Puthenpurakal Abraham, MD, MPH, CMQ

General Practice · Los Angeles, CA

NPI number1932514874
StatusActive
Last updated in NPPESMar 27, 2020

Details

NPI
1932514874
Entity type
Individual (NPI-1)
Name
Dr. Jerry Puthenpurakal Abraham
Credential
MD, MPH, CMQ
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2014
Certification date
Mar 27, 2020
Last updated
Mar 27, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice141443CAYes

Practice location

1400 S Grand Ave Ste 703
Usc-Chmc Family Medicine Residency Program
Los Angeles, CA 90015-3068

Phone 213-741-1106 · Fax 213-741-1434

Mailing address

1400 S Grand Ave Ste 703
Usc-Chmc Family Medicine Residency Program
Los Angeles, CA 90015-3068

Phone 213-741-1106 · Fax 213-741-1434

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